Related Experiment Video
Updated: Aug 30, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Prediction scale of cerebrovascular disease subtypes for high-risk population
Wenguang Yan1, Ru Chen2, Hao Hu3
1Department of Rihabilitation Medicine, Third Xiangya Hospital, Central South University, Changsha 410013. 2402632247@qq.com.
Insights
This study developed a new risk scale to predict subtypes of cerebrovascular disease, differentiating between cerebral ischemia (CI) and cerebral hemorrhage (CH). The scale demonstrated good accuracy in classifying patients into CI or CH groups.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Biostatistics
Background:
- Cerebrovascular disease is a major health concern, broadly classified into cerebral ischemia (CI) and cerebral hemorrhage (CH).
- Accurate subtype prediction is crucial for appropriate clinical management, yet no dedicated predictive scale currently exists.
- This gap highlights the need for a tool to aid in differentiating between CI and CH.
Purpose of the Study:
- To develop and validate a novel risk prediction scale for differentiating between cerebral ischemia (CI) and cerebral hemorrhage (CH).
- To identify key clinical and biochemical factors associated with each cerebrovascular disease subtype.
- To provide clinicians with a practical tool for predicting CI-CH subtypes.
Main Methods:
- A cohort of 1,200 patients with cerebrovascular disease was analyzed, with 1,081 used for scale development and 119 for validation.
- Risk factors were identified through preliminary statistical tests (t-test, Fisher's exact test) and logistic regression analysis.
- Factor scores were determined by odds ratios, and the Youden index was used to establish the optimal cut-off point.
Main Results:
- Nine significant risk factors were incorporated into the CI-CH risk scale, including age, BMI, hypertension grade, diabetes, antihypertensive use, alcohol consumption, uric acid, LDL, and HDL cholesterol.
- The scale effectively classified patients: a score >0 indicated cerebral hemorrhage (CH), while a score ≤0 indicated cerebral ischemia (CI).
- The developed scale achieved a sensitivity of 74.5%, specificity of 77.9%, and overall accuracy of 76.4% in predicting cerebrovascular disease subtypes.
Conclusions:
- The newly established CI-CH risk scale is a valuable tool for clinicians to predict the subtypes of cerebrovascular diseases.
- The scale's predictive performance suggests its utility in clinical practice for guiding diagnosis and treatment.
- Further research may refine the scale and explore its impact on patient outcomes.
Objectives:
Cerebrovascular disease can be roughly divided into 2 subtypes: Cerebral ischemia (CI) and cerebral hemorrhage (CH). No scale currently exist that can predict the subtypes of cerebrovascular diseases. This study aims to establish a prediction scale for the subtypes of cerebrovascular diseases.
Methods:
A total of 1 200 cerebrovascular disease patients were included in this study, data from 1 081 (90%) patients were used to establish the CI-CH risk scale, and data from 119 (10%) patients were used to test it. Risk factors for the CI-CH risk scale were identified by 2 screens, with two-tailed student's t-test and two-tailed Fisher's exact test preliminarily and with logistic regression analysis further. The scores of each risk factor for CI-CH risk scale were determined according to the odds rate, and the cut-off point was determined by Youden index.
Results:
Nine risk factors were ultimately selected for score system, including age (≥75 years old was -1, <75 years old was 0), BMI (<24 kg/m2 was 0, 24-28 kg/m2 was -1, >28 kg/m2 was -2), hypertension grade (grade 1 was 1, grade 2 was 2, and grade 3 was 3), diabetes status (no was 0, yes was -1), antihypertensive drug use (no was 0, yes was -2), alcohol consumption (<60 g/d was 1, ≥60 g/d was 2), uric acid (less than normal was 0, normal was -1, high than normal was -2), LDL cholesterol (<2 mmol/L was 0, 2-4 mmol/L was -1, and >4 mmol/L was -2), and HDL cholesterol (<1.55 mmol/L was 0, ≥1.55 mmol/L was 2). Patients with a score more than 0 were classified as the CH group, Conversely, they were assigned to the CI group; its sensitivity, specificity, and accuracy were 74.5%, 77.9%, and 76.4%, respectively.
Conclusions:
The CI-CH risk scale can help the clinician predict the subtypes of cerebrovascular diseases.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:10Pre-Procedural Guidelines for Assessing Blood Pressure